Heart disease rising in central and eastern Europe

Europe's policymakers are being asked to make improvements in cardiovascular health a major political priority as evidence emerges of the spread of heart disease across social and geographical boundaries.

Cardiovascular disease is already the cause of four million deaths a year in Europe. Mortality from the disease is rising in central and eastern Europe, where it is almost double that of the worst affected countries in the European Union. On current trends, the disease will be responsible for 19 million deaths annually worldwide by 2020.

The Winning Hearts campaign to move heart disease higher up the political agenda was launched this week by the British Heart Foundation and the European Society of Cardiology. Their aim is to ensure that every child born in the year 2000 has the right to live until the age of at least 65 without developing avoidable cardiovascular disease.

The campaign is being addressed not just at national governments but also at the European Commission, which is currently putting the finishing touches to a new public health action programme that could take effect from autumn 2001 or January 2002.

New research released by the British Heart Foundation confirms the wide disparities in coronary heart disease in Europe. In France it kills 57 out of 100000 people between the ages of 35 and 74, compared with 246 in the Republic of Ireland and 188 in the United Kingdom.

The disease also places a heavy burden on Europe's economies. At the campaign's conference in Brussels this week, it was estimated that 74 billion euros are spent annually by EU governments treating cardiovascular disease. Another 106 billion euros are incurred in extra costs stemming from reduced productivity and the economic impact of illness and death.

The British Heart Foundation's statistics also underline the fact that the prevalence of risk factors such as obesity and diabetes are increasing across Europe. A survey across the European Union completed in 1997 showed that between 27% and 35% of adults were overweight, and between 7% (Italy and France) and 12% (United Kingdom)were obese.

Smoking, the cause of 22% of male and 4% of female deaths from cardiovascular disease in Europe, continues to give concern. Trends over the past 20 years show that the habit is declining among men in northern, southern, and western Europe, but in some countries women are now smoking nearly as much as men, and tobacco consumption seems to be rising among teenagers.

Evidence that public policy measures can improve the prevention of cardiovascular disease was given to the Brussels conference by Jussi Huttunen, director of Finland's national health institute and president of the Finnish Heart Association. In the 1960s, the country had exceptionally high death rates from cardiovascular disease, the national diet had a high saturated fat and cholesterol content, and 70% of males were smokers.

With a mixture of awareness campaigns, the active involvement of the population, and the implementation of national nutrition and antismoking programmes, cardiovascular mortality has decreased by 75% for men and women under 64 years of age.

The Winning Hearts campaign hopes that Finland's experience and appropriate policy changes in other areas—from transport and agriculture to employment and education—can achieve similar results elsewhere in Europe. It published a survey from the European Heart Network, which showed that politicians in 13 European parliaments attached high priority to the prevention of disease but that, because of immediate political pressures, prevention often took second place to treatment.

European Cardiovascular Disease Statistics is available from the British Heart Foundation, PO Box 2216, London W1A 1WU, price £8.99.

The percentage of total energy from fat and from fruit and vegetables in people's diet varies across Europe (1997 data

(Credit: SOURCE: BRITISH HEART FOUNDATION)